Emergency Medicine Certificate Program

Inaugural Class Fall 2018

The Certificate in Emergency Medicine is for physician assistants who are interested in obtaining specialized education in emergency medicine, to prepare them for a position in a high acuity emergency department.

The Emergency Medicine Certification Program at Nova Southeastern University will provide physician assistants a chance to gain additional knowledge of emergency medicine in an online curriculum. Currently, one-year residency programs exist throughout the country in which advanced practitioners can supplement their education. Most of the time, this requires relocation and is a financial obstacle. This program, however, is unique in that we will provide didactic coursework remotely, but will also require onsite training to teach clinical skills and also assess the student using simulation. This certificate program is targeting advanced practitioners who are currently employed, but seeking additional coursework in emergency medicine to make them more marketable for a position in an emergency department.

This certificate program was discussed with multiple emergency department medical directors who felt that this program would greatly contribute to an applicant's curriculum vitae.

ADMISSION REQUIREMENTS

Requirements for admission into this certificate program are to be a graduate of a U.S. or foreign accredited university with a minimum of a Bachelor of Science in Physician Assistant Studies with a minimum GPA of 2.5. Students must have an active PA-C license in good standing. Two letters of recommendation from a health care professional are required.

CURRICULUM

At the completion of the Certificate in Emergency Medicine, students will have completed eighteen credit hours (6 courses each being 3 credit hours). Two courses will be offered each semester, so a student can complete this program in one year.

Recognize the following types of cardiac dysrhythmias as well as their treatments: ventricular, supraventricular, and disorders of conduction. Differentiate when one should defibrillate versus cardiovert a patient with a dysrhythmia versus cardiac pacing.

Describe the pathophysiology of mitral valve prolapsed, aortic stenosis and mitral regurgitation and its clinical consequences.

Describe the risk factors, clinical features, diagnostic evaluation, and treatment of endocarditis/myocarditis and pericarditis. Describe some of the complications that can be seen with prosthetic heart valves and the considerations when a patient with such a valve presents with a bleeding problem.

Describe the ED treatment options for both mild and severe decompensated heart failure and how lab testing may help in diagnosis.

Compare and contrast the clinical presentation, ED treatment, and disposition of patients that present with hypertensive urgency vs. hypertensive emergency.

Define the risk factors for aortic aneurysm and aortic dissection, presenting symptoms, and the appropriate ED work up and treatment.

Describe some of the risk factors, symptoms and treatment for both arterial and venous thromboembolic disease.

Describe diagnostic options for suspected pulmonary embolism as well as their sensitivity and specificity. Discuss treatment options for an acute pulmonary embolism.

Describe some presentations for hypertrophic cardiomyopathy and dilated cardiomyopathy.

Describe the presentation and treatment of pericardial effusion and tamponade.

Hematologic Learning Outcomes:

Examine the differential diagnosis of anemia and describe how to distinguish each type based on analysis of the complete blood count (CBC).

This course will review Neurologic, Infectious Disease and Pediatric Emergencies. The student will feel comfortable in appropriately recognizing these disorders, ordering the proper tests and treating the disease process.

Neurologic Learning Outcomes:

Compare and contrast the pathophysiology, clinical presentation, diagnostic evaluation, and treatment of TIA versus CVA. List the exclusion criteria for TPA in a stroke patient.

Describe how a patient with a subdural or intracerebral hemorrhage may present and some of the risk factors for these conditions.

Explain the role of blood thinning reversal agents and antihypertensives in the acute treatment of intracranial hemorrhage.

Explain the difference between central and peripheral vertigo. List the main causes of ataxia and gait disturbance.

Compare and contrast the clinical presentation, diagnostic evaluation, and treatment of following types of headaches: tension, migraine, cluster, spinal, meningitis, pseudotumor cerebri and intracranial bleed. Explain the role of CT imaging and lumbar puncture in the diagnostic evaluation of a suspected subarachnoid hemorrhage.

Evaluate the pathophysiology and rationale for aggressive early goal directed therapy in the ED treatment of sepsis and septic shock.

Describe the management of occupational exposure of a health care worker to potentially infectious bodily fluids, including the indications for the initiation of HIV prophylaxis.

List the common opportunistic infections that occur in patients with AIDS, and how such infections are treated: cryptococcal meningitis, toxoplasmosis, pneumocystis pneumonia, cytomegalovirus retinitis, esophageal candidiasis, and tuberculosis.

This course will review the OB/GYN, Ophthalmological, ENT and Psychiatric Emergencies. The student will be able to recognize, order the appropriate tests and treat these emergencies.

OB/GYN learning outcomes:

Describe the various types of miscarriages and the appropriate ED treatment and disposition. Explain the symptoms of ectopic pregnancy and how the quantitative HCG levels and ultrasound aid in its diagnostic evaluation.

This course will review Trauma, Non-Traumatic Musculoskeletal Disorders, Abdominal and Chest Emergencies. The student will be able to recognize and treat the disorders. The student will feel comfortable seeing and treating these patients in the Emergency Department.

Trauma Emergencies Learning Outcomes:

Describe how to perform a primary and secondary survey in evaluation of the trauma patient as outlined in the Advanced Trauma and Life Support (ATLS) guidelines.

Describe the role of the focused assessment with sonography in trauma (FAST) exam in the trauma patient.

Describe the signs and symptoms of hemorrhagic shock.

Name the indications and contraindications for emergency procedures in the trauma patient such as: endotrachial intubation, cricothyroidotomy, tube thoracostomy, emergency department thoracotomy, and central venous catheter insertion. Describe in detail how each of these procedures are performed, and their possible complications.

Evaluate the diagnostic and treatment priorities in the head trauma patient. Describe the principle of primary and secondary brain injuries in the head trauma patient.

Explain the clinical, diagnostic, and therapeutic concerns of trauma in the pregnant patient.

Describe the management of spinal cord injuries. Name the indications and potential benefit of steroids in patients with significant neurologic deficits following spinal cord trauma.

Describe how abdominal wall hernias are diagnosed and explain the appropriate treatment and disposition patients that present with this condition.

Explain how the following disorders of the esophagus may present, how they are diagnosed, and their appropriate treatment: esophagitis, GERD, caustic exposures, dysmotilities, Boerhaave’s syndrome, foreign bodies, Mallory-Weiss syndrome, strictures and stenosis, tracheoesophageal fistulas, and varices.

Describe the complications of liver failure and cirrhosis, such as bleeding, hepatic encephalopathy, hepatorenal syndrome, spontaneous bacterial peritonitis. List the laboratory abnormalities that may be encountered with these conditions.

Explain how cholecystitis and ascending cholangitis may present, how one would work up a patient with this suspected diagnosis, and the appropriate management of this disease.

Describe the common symptoms of pancreatitis, peptic ulcer disease and gastritis, and how they may be managed in the ED.

Describe the manifestations of mesenteric ischemia as well as the risk factors, diagnosis, and treatment.

Describe the typical and atypical manifestations of acute appendicitis as well as the diagnostic approach to the patient with possible appendicitis.

Describe the syndrome of intussusception, how it is diagnosed, and how it is managed.

Describe the manifestations of the following disorders of the rectum and anus as well as the appropriate treatment: fissures, fistulas, internal/external hemorrhoids, rectal foreign bodies, rectal prolapse, and perirectal abscesses.

Chest Emergencies Learning Outcomes:

Explain the typical presentation and the appropriate management of croup, epiglottitis, and bronchiolitis.

Describe an approach to a patient with an upper airway obstruction.

List some of the complications of a tracheostomy and how they are evaluated.

Discuss some of the etiologies of noncardiogenic pulmonary edema and how to treat this entity.

Discuss the pathophysiology and nuances of treatment of an exacerbation of asthma/COPD.

What are some of the complications of cystic fibrosis?

Describe the clinical presentation, diagnostic evaluation, and treatment for a patient that presents to the ED following exposure to toxic gases/fumes.

This course will review Environmental, Toxicological and Dermatological Emergencies. The student will be able to recognize and treat the disorders. The student will feel comfortable seeing and treating these patients in the Emergency Department.

Environmental Emergencies Learning Outcomes:

Describe the pathophysiology, diagnosis, and treatment of frostbite, trench foot and hypothermia.

Explain the relationship between hypothermia and cardiac dysrhythmias and cardiac arrest.

Describe the clinical presentation, diagnostic evaluation, and treatment of a patient with heat stroke and heat exhaustion.

Explain the clinical features, diagnostic evaluation, and treatment of bites from the following marine animals, venomous fish, snake bites and spiders. Describe the treatment of coral-induced injuries.

Explain antibiotic therapy for an injury occurring in the marine environment.

Describe the pathophysiology of barotrauma of ascent and barotrauma of descent during deep-sea diving.

Compare and contrast “dry drowning” with “wet drowning”.

Describe the pathophysiology of the fluid and electrolyte abnormalities that can be seen in the burn patient. Explain the method of fluid resuscitation in these patients. Describe how to estimate burn size and depth and criteria to transfer patient to burn unit.

This course will review Renal/Urogenital, Metabolic and Immunologic Emergencies. The student will learn how to identify and treat these emergencies. The student will be comfortable in treating these disorders in the Emergency Room setting.

Renal and Urogenital Emergencies Learning Outcomes:

Describe the signs, symptoms and ED treatment of acute renal failure. Evaluate the indications for emergent hemodialysis, with and without access.

Compare the chronic complications of hemodialysis and peritoneal dialysis

Describe the management of vascular access associated hemorrhage in the hemodialysis patient.